Three Rivers Medical, from May 1, will cease its “extended hours” of closing at 8pm on weekdays and operating 9am-6pm on weekends and public holidays.
Dr Aitcheson said the practice would still operate similar hours to other GP practices in Gisborne.
That is 8am to 5pm weekdays and 9am to 1pm weekends and public holidays.
The practice serves a large, high-needs and vulnerable population and has operated those extended hours since it opened in 2012.
“We know our people,” said Dr Aitcheson. “Our people often access (healthcare) by crisis. Often that crisis isn’t within standard business hours. We are very aware of that.”
Three Rivers Medical had looked at all avenues to serve that population but there were no other options.
The practice would not “close its books” to new patients, he said. “That is not our kaupapa.”
New Zealanders had a fundamental right to access primary healthcare, he said.
Primary healthcare at saturation level: GP
Dr Aitcheson said more than half of GP practices in the country had closed books.
A key funding issue for GPs was that the capitation rate (a government fixed payment for each enrolled person) was not indexed to inflation.
Dr Aitcheson said the capitation rate increased by 2.89 percent last year when inflation was in excess of 7 percent.
GP practices were competing in a global employment market and doctors would go where the money was.
The GP sector was reliant on overseas doctors but there were immigration difficulties. Many GPs were older and close to retirement.
Dr Aitcheson said young doctors who chose general practice over a hospital-based speciality would forfeit millions of dollars in lifetime earnings.
The “sweet spot” at Three Rivers Medical was 13 fulltime employees, but the practice only had 10.5 GPs.
Moves to create pay parity for primary healthcare nurses with the wages of public hospital nurses excluded nurses who worked in general practice.
This was “just nuts”, he said.
GPs were trying to do “business as usual” during the pandemic, as well as being the “main workforce that was fighting the pandemic”.
The public did not realise how important “business as usual” was.
Dr Aitcheson said an extra GP per 10,000 people would have profound effects.
Studies showed life expectancy would increase while the perinatal mortality rate and cardiovascular mortality would decrease.
The country’s emergency departments, including Gisborne Hospital’s ED, had experienced high numbers of patient presentations for some years, he said.
He put that down to the “culmination of two decades of underfunding of primary healthcare”.
He did not think primary healthcare was broken but it was “saturated”. It could not take any more workload.
Hospital EDs needed adequate resourcing but the reason EDs were so busy was that primary care had been marginalised.
“It’s getting to the point where within 10 to 15 years the whole concept of being able to visit a doctor in your community is under threat,” Dr Aitcheson said.
“When that happens, that’s a huge, huge problem for our health system.”
